
<script>

</script>

<div id="googleMap" style="width:100%;height:380px;"></div>
	<div class="row-fluid sortable">
				<div class="box span12">
					<div class="box-header well" data-original-title>
						<h2 id="rph-title">Menambahkan Data RPH</h2>
					</div>
					<form id="rph-form" method="POST" action="<?php echo base_url();?>rph/add_rph">
						<div class="box-content">
							<table class="table" style="width: 50%; float: left;">
								<tbody>
									<tr>
										<td style="width: 10%;">Nama</td>
										<td style="width: 40%;">
											<input style="width: 90%;" id="nama" name="nama" type="text"></input>
										</td>    
									</tr>
									<tr>
										<td style="width: 10%;">Alamat</td>
										<td style="width: 40%;">
											<input style="width: 90%;" id="alamat" name="alamat" type="text"></input>
										</td>          
									</tr>
									<tr>
										<td style="width: 10%;">Kota</td>
										<td style="width: 40%;">
											<div class="controls">
												<?php if(isset($all_kota)): ?>
													<select id="id_kota" data-rel="chosen" name="id_kota">
														<?php foreach($all_kota->result_array() as $row): ?>
															<option <?php if(isset($rph)) if($rph[0]['ID_KOTA'] == $row['ID_KOTA']) echo "selected='selected'"; ?> value="<?= $row['ID_KOTA']; ?>"><?= $row['NAMA_KOTA']; ?></option>
														<?php endforeach; ?>
													</select>
												<?php endif; ?>
											</div>
										</td>          
									</tr>
									<tr>
										<td style="width: 10%;">No Telp</td>
										<td style="width: 40%;">
											<input style="width: 90%;" id="no_telp" name="no_telp" type="text"></input>
										</td>          
									</tr>
									<tr>
										<td style="width: 10%;">Email</td>
										<td style="width: 40%;">
											<input style="width: 90%;" id="email" name="email" type="text"></input>
										</td>          
									</tr>
									<tr>
										<td style="width: 10%;">Kode Pos</td>
										<td style="width: 40%;">
											<input style="width: 90%;" id="kode_pos" name="kode_pos" type="text"></input>
										</td>  
									</tr>
									<tr>
										<td style="width: 10%;">Tanggal Berdiri</td>
										<td style="width: 40%;">
											<div class="controls" style="margin-left: 0px; width: 100%;">
												<input name="tanggal_berdiri" id="tanggal_berdiri" style="width: 90%;" type="text" class="datepicker" id="datepicker"></input>
											</div>
										</td>          
									</tr>
									<tr>
										<td style="width: 10%;">Produksi Normal</td>
										<td style="width: 40%;">
											<div class="controls" style="margin-left: 0px; width: 100%;">
												<input name="produksi_normal" id="produksi_normal" style="width: 90%;" type="text"></input>
											</div>
										</td>          
									</tr>
									<tr>
										<td style="width: 10%;">Jumlah Dokter Hewan</td>
										<td style="width: 40%;">
											<div class="controls" style="margin-left: 0px; width: 100%;">
												<input name="jumlah_dokter_hewan" id="jumlah_dokter_hewan" style="width: 90%;" type="text"></input>
											</div>
										</td>          
									</tr>
									<tr>
										<td style="width: 10%;">Lisensi</td>
										<td style="width: 40%;">
											<div class="controls" style="margin-left: 0px; width: 100%;">
												<input name="lisensi" id="lisensi" style="width: 90%;" type="text"></input>
											</div>
										</td>          
									</tr>
									<tr>
										<td style="width: 10%;">Jumlah Juru Sembelih</td>
										<td style="width: 40%;">
											<div class="controls" style="margin-left: 0px; width: 100%;">
												<input name="jumlah_juru_sembelih" id="jumlah_juru_sembelih" style="width: 90%;" type="text"></input>
											</div>
										</td>          
									</tr>
									<tr>
										<td style="width: 10%;">Jumlah Keurmaster</td>
										<td style="width: 40%;">
											<div class="controls" style="margin-left: 0px; width: 100%;">
												<input name="jumlah_keurmaster" id="jumlah_keurmaster" style="width: 90%;" type="text"></input>
											</div>
										</td>          
									</tr>
									<tr>
										<td style="width: 10%;">Info</td>
										<td style="width: 40%;">
											<textarea name="info" id="info" style="width: 90%;"></textarea>
										</td>          
									</tr>
									<tr>
										<td></td>
										<td>
											<input type="reset" class="btn" value="Reset" onclick="resetForm();"></input>
											<input id="button-panel" type="submit" class="btn"></input>
										</td>
									</tr>                            
								</tbody>
							</table>
						 <div id="googleMap2" style="float: left; width:50%;height:300px;"></div>
						 <input type="hidden" id="id-rph" name="id-rph" value="">
						 <input type="hidden" id="lat" name="lat" value="">
						 <input type="hidden" id="lng" name="lng" value=""> 
					</div>
					</form>
				</div><!--/span-->
				
			<div><!--/row-->
			